I know a few of you have pushed the idea of getting slides read by experts. I thought this exchange with Dr. Epstein, one of the top pathologists, would be interesting. I really expected him to refer me to his web-site if I wanted to send him the slides.
Both volume and grade are important. The pathologists at Henry Ford should be ok.
I can use some advice. I have just been dx. with PC at the Univ. of Michigan. From my readings, I understand it is a good idea to get a second opinion. Currently, I have requested that the slides be forwarded to Ford Hospital as I will be consulting with Dr. Menon.
Would it still make sense to have the slides forwarded to you at some point (also, is the turnaround fairly rapid)?
One other question. I have been reading the Strum and the Walsh books. I have 5 positive cores out of 12. The two worst are G 4+3, but each is 5% of the core. I understand the significance of the Gleason score. But what about core volume. Obviously lower is better than higher (at least I would think so), but does it have any significance in fashioning a prognosis.
63 years old
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.
History of BPH/prostatitis.
PCA-3 test: 75.9 (bad news, guaranteeing I have to do....):
Biopsy on 11/30/09
Biopsy Report—Prostate Cancer
5 out of 12 positive
Gleason 4+3. More specifically:
2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:
2 cores are 4+3 (5%)--
1 core 3+4 (30%)
no peri-neural invasion
prostate is 45 grams
Latest: Have set up an appointment at Umich with surgeon, radiation guy, general medical oncologist on Monday, 12/14. Trying to also set up appointment with Dr. Menon at Ford Hospital. Looking at another reading of the slides.